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Biomedical subjects

J W Dilley

Publications and source records attributed to J W Dilley.

16 recordsLinked to original sources
PubMed1992

A roundtable discussion: hospital leaders discuss QI implementation issues.

To address critical questions regarding the practical application of quality improvement (QI) concepts within health care, the Joint Commission visited six hospitals that have been implementing QI for several years. After the site visits, the leaders of these hospitals participated in a roundtable discussion of QI issues. The discussion centered around nuts-and-bolts topics, such as leadership, implementing QI, barriers/resistances, medical staff involvement, cultural change, institutionalizing QI, and external environment. The roundtable discussion is excerpted in full from a new book, Striving Toward Improvement: Six Hospitals in Search of Quality, which tells the stories of the six hospitals and their transitions to QI.

Attitude↗
PubMed1992

Management and residential placement problems of patients with HIV-related cognitive impairment.

The Neuropsychiatric AIDS Rating Scale, which classifies HIV-related cognitive impairment along a six-stage continuum, was used to explore the relationship between the severity of impairment and management and residential problems among 318 persons in San Francisco with suspected HIV-related cognitive impairment. Nearly half of the sample were in the moderate, severe, or end stage of impairment. One-third of the 318 persons, most of whom were in the moderate and severe stages, were reported to present residential placement problems. The management problems most associated with placement difficulties were home safety, wandering, confusion, and memory difficulties. More than a fourth of the moderately to severely impaired patients were living alone with no outside help or were homeless and living on the streets. Results of this study support the development of specialized residential programs for patients with HIV-related cognitive impairment.

AIDS Dementia Complex↗
PubMed1988

Neuropsychiatric aspects of AIDS dementia complex: a report on a clinical series.

The AIDS Dementia Complex (ADC) frequently occurs in individuals with Acquired Immunodeficiency Syndrome (AIDS). We report on a clinical series of 33 patients with either AIDS or AIDS-Related Complex (ARC), who were referred for neuropsychological evaluation. This clinical series supports the developing understanding that AIDS spectrum patients often demonstrate impairment on tasks involving abstract reasoning, memory, speeded mental processing and motoric slowing. This series helps to draw attention to a small subgroup of patients, with no previous psychiatric history, who after infection with the human immunodeficiency virus (HIV), present with hyperactivity, euphoria and grandiose delusions. ADC would appear to bear with it the increased possibility of the development of secondary mania.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Routine care and psychosocial support of the patient with the acquired immunodeficiency syndrome.

Due to the magnitude of the AIDS epidemic in San Francisco, centralization of services has been essential for providing maximal patient care and support, and allowing for efficient performance of clinical investigation. While other locales with fewer numbers of documented cases may not have the need for such extensive organization, lessons can be adopted from the San Francisco experience. It is never an easy task to provide routine medical care and psychosocial support for a young patient with an ultimately fatal illness. Close cooperation of the medical establishment and the community at large, with governmental assistance and support, facilitates this difficult undertaking.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Findings in psychiatric consultations with patients with acquired immune deficiency syndrome.

Thirteen of 40 patients with acquired immune deficiency syndrome (AIDS) admitted to the wards of a large city hospital were seen by the staff of a psychiatric consultation service. Eleven were gay men and two were bisexual men. "Depression" was the stated reason for referral of 10 patients; of these, two met DSM-III criteria for major depression, one had dysthymic disorder, and seven had adjustment disorder with depressed mood. Recurrent psychological themes of the 13 patients were: dealing with a life-threatening illness, uncertainty about the implications of an AIDS diagnosis, social isolation, and guilt over their previous life style. The role of the primary physician and of the mental health professional in the psychological care of AIDS patients is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Ethical dilemmas in caring for patients with the acquired immunodeficiency syndrome.

Caring for patients with the acquired immunodeficiency syndrome (AIDS) raises ethical dilemmas about when to provide life-sustaining treatments such as mechanical ventilation and cardiopulmonary resuscitation. In addition, many patients become mentally incompetent and unable to participate in decisions. Homosexual men may want their lover or a friend to make decisions for them, but the patient's partner or friend cannot make these decisions unless he is legally designated. Decision-making guidelines may be hard to implement because caring for patients with AIDS is stressful. We describe three cases that illustrate the difficult ethical dilemmas and stresses of caring for these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1968

Association structure.

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Organization and Administration↗